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Learn About Requirements for Medicaid in Nebraska

UPDATE: Medicaid care in 2020 will take into account the same requirements and application steps as it did in recent years.

Medicaid benefits eligibility is made available to qualifying low-income Nebraska residents. Low-income candidates who meet Medicaid eligibility include the elderly, disabled applicants, pregnant women, children and parents. Eligible applicants must meet income, age and other Medicaid eligibility requirements to receive financial assistance for local medical services.

As a general rule, all – not most – of the Medicaid qualifications in Nebraska must be met in order for someone who is eligible for Medicaid to receive full benefits.

Who meets requirements for Medicaid in Nebraska?

Medicaid benefits provide low-cost health care services to one in 10 Nebraskans. Low-income Nebraskans who meet Medicaid eligibility requirements may qualify to apply for and receive Medical Assistance (Nebraska Medicaid).

If all Medicaid eligibility requirements are met, beneficiaries will receive financial assistance for medically necessary services such as doctor visits, hospital care, dental care, eye care and hearing and physical therapies. Additionally, patients who meet Medicaid benefits eligibility will receive assistance paying for nursing home costs, home health care services, laboratory and X-ray costs and prescribed drugs.

Various services that are not covered under Medicaid eligibility, such as medical transplants and cosmetic surgery, have limitations and requirements, and patients must request approval from the Medicaid program before coverage will occur. Applicants who do not meet Nebraska Medicaid eligibility requirements may be eligible to receive affordable health care coverage through Nebraska’s Qualified Health Plans program or Advanced Premium Tax Credits.

Learn more about Medicaid requirements by downloading our comprehensive guide.

What Are the Requirements for Medicaid in Nebraska?

In the state of Nebraska, Medicaid services are available to qualifying low-income or very-low-income applicants who meet state-specific eligibility requirements. Medicaid eligibility requirements require a beneficiary to be low-income, elderly, disabled or pregnant, or to be low-income and have children.

Additionally, Medicaid benefits are available to candidates who are 65 or older or who are under the age of 65 and have a disability. Requirements for Medicaid also apply to candidates who are 18 or younger.

Dependent children who meet the requirements of the Aid to Dependent Children Program may also be eligible for Medicaid. As a whole, the following Medicaid requirements apply to all potential beneficiaries planning to enroll in Medicaid benefits in Nebraska:

  • An application must be completed
  • Beneficiaries must be U.S. citizens or hold legal alien status
  • Applicants must reside in Nebraska
  • A Social Security Number is required
  • Income restrictions must be satisfied
  • Current health insurance policies must be stated, if applicable
  • Household members must be noted

Children who do not meet Medicaid eligibility requirements and who do not have other health insurance coverage may be eligible to receive assistance from the Children’s Health Insurance Program (CHIP). Nebraska CHIP is an expansion of Nebraska Medicaid and provides many of the same Medicaid services. Download our helpful guide to learn about the different requirements for Medicaid.

To qualify for Medicaid, candidates must fill out an electronic eligibility form online. Applicants who believe they meet Nebraska Medicaid benefits eligibility requirements must show proof that Medicaid assistance is needed.

To meet Medicaid eligibility requirements, candidates must consider a variety of financial resources that will be applied to their Medicaid applications. These resources will affect the applicant’s income level; however, these financial resources may not be given away before applying for Medical Assistance in Nebraska.

Medicaid benefits eligibility will be determined based on the following additional resources: the value of the home in which the applicant resides in, one motor vehicle, property used to operate a trade or business (including land, equipment and machinery) and irrevocable burial funds.

In addition to these amounts, other resources that impact NE Medicaid benefits eligibility must not exceed the following amounts per household: $4,000 for households of one, $6,000 for households of two and $25 for each additional household member.

In any case, it is important to note that Medicaid eligibility requirements do not apply to children under 18 who are eligible for Medicaid or to low-income pregnant women.

What Are the Income Requirements for Medicaid in Nebraska?

Candidates interested in Medicaid benefits in NE must meet standard income restrictions that deem the applicant is unable to pay for basic living and medical needs. However, Medicaid eligibility requirements in NE may require a beneficiary to spend a portion of their income on medical expenses. Co-payments may also be the responsibility of the patient.

For example, Medicaid benefits eligibility requires households of one to earn less than $15,800 per year, households of two must earn less than $21,307 per year, households of three must earn less than $26,813 per year, households of four must earn less than $32,319 per year.

In addition, households of five must earn less than $37,825 per year, households of six must earn less than $43,331 per year, households of seven must earn less than $48,851 per year and households of eight must earn less than $54,384 per year.

Furthermore, Medicaid benefits require households of more than eight people to add on $5,533 per additional household member.

What Are the Medicaid Application Guidelines in Nebraska?

Once Nebraska Medicaid eligibility requirements are met, candidates should go through the Medicaid application guidelines. Applicants can apply for Medicaid benefits online using the Department of Health & Human Services’ ACCESS Nebraska website. Applicants who meet Medicaid benefits eligibility will need to create an online account before applying. Candidates can apply with or without a personal PIN.

Candidates who meet the requirements for Medicaid but who do not have internet access may contact the ACCESS Nebraska Customer Service staff by telephone to request a paper application in the mail.

Additionally, candidates can visit a local Health & Human Services office to apply for Medicaid benefits in person. Applicants who meet NE Medicaid benefits eligibility will have access to telephones and kiosks at their local Health & Human Services office.